Welcome to Docscopy section of MedBound Times.
Unlocking the doors to women's healthcare, Priya Bairagi, Darshit Patel and Vithya Manoharan of MedBound Times converse with Dr. Tanuj Lawania, as she shares her experiences, challenges, and triumphs in the pursuit of fostering optimal health.
Dr. Tanuj Lawania completed her MBBS from KIIT University, Orissa, India, in 2017. She then pursued DNB in Obstetrics and Gynaecology from Mazumdar Shaw Medical Center, Bangalore, India. (2018-2022).
She is currently working at Sharda Medical College, Greater Noida, India.
Hello Mam and welcome to this DocScopy session with MedBound Times. Please tell us something about your professional life.
Dr. Tanuj Lawania: Alright! So, the medical journey has been very long. After my 12th, I took 1 year off, and then I got into MBBS. My time in MBBS was really good; the colleagues I had, and all my teachers were amazing. I learned incredible things during my time in medical school. My internship period was absolutely fruitful. During the internship, I was posted in different branches and specialties, which helped me realize where I wanted to dedicate my career after working through the internship.
My internship was a time of great learning. I learned how to put in an IV cannula, how to suture, and the basic treatments for various diseases. While working, I gained insights into managing trauma cases. When I was posted in the field of medicine, I understood how to diagnose certain diseases. Moving on to obstetrics and gynecology, I realized that this was the specialty I wanted to pursue in the future.
There's a rampant and unregulated use of medical products, particularly abortion pills, without proper medical supervision. People use these medications without consulting a doctor.Dr. Tanuj Lawania
Did you undergo a phase of mentorship under Dr. PS Pujari, and if so, could you provide some insights into that experience?
Dr. Tanuj Lawania: Yes, during our internship, there was a significant moment when I was posted in the surgery department. At that time, Dr. P.S. Pujari was our Head of Department for Surgery. I had the privilege of being in his unit. Dr. Pujari stood out as someone who placed immense trust in us. We accompanied him on rounds and presented cases as post-graduate students, a practice that greatly facilitated our learning process.
I distinctly recall my first experience in the operating theater. I was with Dr. Pujari, and he entrusted me with holding a scalpel for the first time. It was a defining moment that sparked my interest in the surgical field.
Furthermore, I had the opportunity to assist with a laparoscopic surgery during my internship. Dr. Pujari assigned me a role in a laparoscopic cholecystectomy. While I was assisting by managing the camera, he made a lighthearted remark, suggesting that if I continued this way, I might become a gynecologist instead. Little did I know that this offhand comment would resonate with me and come true in my career path.
Dr. Pujari's impact on me and my colleagues was profound. He is a remarkable teacher who commands great respect. His mentorship style involves encouraging us to learn and excel. For medical graduates like us, having him as a mentor is an unparalleled privilege. We all aspire to have someone who pushes us to achieve greater things, believes in our capabilities, and guides us in acquiring knowledge.
Have you observed any common misconceptions among patients regarding gynecology and women's health, and do you believe there are systemic issues that should be addressed in this field?
Dr. Tanuj Lawania: Yes, the situation I face is based on my practice in the northern region of India, an area that's still underdeveloped concerning women's health. This context brings about numerous misconceptions. Firstly, there's the prevailing belief that women are disinterested in their health or that their family members overlook their well-being. It seems they're often the last to seek medical attention, even if they're facing health issues.
Adding to this, there's a rampant and unregulated use of medical products, particularly abortion pills, without proper medical supervision. People use these medications without consulting a doctor, resulting in cases of incomplete abortion and severe bleeding. This often leads to anemia and critical situations where immediate evacuation is required to save lives.
Furthermore, delayed medical consultation is a common trend among this segment of society. Turning to menstrual hygiene, there's a significant lack of awareness, primarily within the middle-class and lower-middle-class populations—segments that form a major portion of our country's populace.
The strong preference for male offspring is another issue. This desire prompts them to repeatedly attempt pregnancies in the hope of having a male child. This is a situation I genuinely believe I can impact positively since I've chosen this field. I aim to raise awareness using videos or other mediums, communicating in the local language of Hindi, prevalent in northern India.
Through these efforts, I hope to convey that a woman's well-being directly influences the family's health. The majority of women manage household responsibilities, and if they fall ill, it affects everyone, including their husband and children. Educated and healthy women can also educate others. My Head of Department and fellow postgraduate students used to emphasize that educating one woman can benefit four or five others. By empowering one person, we indirectly empower multiple.
Most of these individuals are uneducated or possess limited education, leading to a lack of understanding about their own bodies. As practitioners, it's our responsibility to not only treat them but also create awareness. Even in our busy lives, dedicating time to make a societal impact, especially for the future generations, is crucial.
Are people generally open about discussing women's health issues and concerns?
Dr. Tanuj Lawania: I believe it greatly depends on the doctor's approach. If a doctor can establish a sense of comfort, patients are more likely to open up about anything. Personally, I've observed that when I engage with individuals, aiming to extract information, I'm at my best when I'm fully present with the patient. This approach is particularly crucial when patients are hesitant or concealing details.
In my opinion, as a doctor, passing judgment is not our role. We must remain non-judgmental when interacting with patients. For instance, if an unmarried girl seeks consultation while being pregnant, instead of forming judgments, our focus should be on discussing the significance of contraception and providing proper treatment. The legal framework in India, including the Medical Termination Bill, is comprehensive and in favor of the people. When compared to other countries, our laws are more considerate.
In such situations, our foremost duty is to ensure the patient feels at ease. When someone comes to you with fear, entrusting their confidence in you, it's paramount to make them comfortable. This approach resonates with my belief – that seeing patients without judgment, purely with the intention of aiding them and raising awareness, can have a positive impact.
What advice do you offer patients about managing nutrient supplements during pregnancy, especially when faced with challenges like difficulty following recommendations and switching doctors?
Dr. Tanuj Lawania: When dealing with Antenatal and Postnatal patients, various factors come into play. Patients who are well-educated and financially capable of accessing quality healthcare tend to follow medical advice diligently. They often stick to one doctor and build a strong rapport. This level of trust leads to their adherence to recommended treatments. Then, there is the middle segment of society. These individuals also tend to listen and try to follow medical guidance.
However, a different scenario emerges with the lower strata of society, where education is lacking. Understanding the significance of supplements like antenatal iron and calcium is a challenge. The government supplies iron and calcium tablets for free through initiatives supported by ASHAs and similar healthcare workers. Although the government's efforts are commendable, there remains a gap in knowledge and compliance.
Some patients from this segment do heed medical advice, even purchasing and taking recommended medications. Nevertheless, there persists a gap where some individuals fail to adhere to these instructions. This gap represents a deficiency that requires attention. Creating awareness among this demographic is crucial.
As a gynecologist, you can take action within your region. If your hospital permits, organizing special camps could be beneficial. In these camps, you can emphasize the importance of antenatal supplements and educate attendees about their benefits. Additionally, providing some supplements for free could incentivize usage, as the concept of receiving something without cost is alluring in India. These efforts are likely to encourage more people to try these supplements, leading to improved health outcomes.
Collaborating with existing organizations, like the society of gynecologists in India, can enhance your impact. By identifying areas with high attrition rates or low healthcare utilization, you can strategically plan these awareness campaigns and interventions. Hosting talks in local languages will ensure that information is accessible and comprehensible.
While achieving comprehensive change will take time, it is a feasible endeavor. Through consistent and targeted efforts, medical professionals can bridge the awareness gap and improve the overall health and wellbeing of pregnant women in underserved communities.
Stay tuned for the second part of this interview!